Nursing Elites

1. A client is diagnosed with hyperthyroidism. The nurse anticipates which of the following medications to be ordered?

• A. Levothyroxine
• B. Propylthiouracil
• C. Lithium
• D. Metoprolol

Correct answer: B

Rationale: The correct answer is B: Propylthiouracil. Propylthiouracil is an antithyroid medication used to manage hyperthyroidism by inhibiting the synthesis of thyroid hormones. Levothyroxine (Choice A) is typically used to treat hypothyroidism, the opposite of hyperthyroidism. Lithium (Choice C) is not used to treat hyperthyroidism but is commonly used to manage bipolar disorder. Metoprolol (Choice D) is a beta-blocker that may be used to manage symptoms like tachycardia associated with hyperthyroidism, but it is not the primary treatment for the condition.

2. Which of the following ethical principles is demonstrated when a nurse provides truthful information to a patient?

• A. Veracity
• B. Autonomy
• C. Justice
• D. Nonmaleficence

Correct answer: A

Rationale: The correct answer is A: Veracity. Veracity is the ethical principle of truthfulness and honesty in communication. When a nurse provides truthful information to a patient, it demonstrates integrity and respect for the patient's right to know the truth about their health condition and treatment. Choice B, Autonomy, refers to respecting the patient's right to make their own decisions. Choice C, Justice, involves fairness and equality in healthcare decisions. Choice D, Nonmaleficence, relates to the obligation to do no harm and prevent harm to the patient.

3. A client with hyperthyroidism is receiving radioactive iodine therapy. The nurse should monitor for which of the following side effects?

• A. Hypothyroidism
• B. Hyperkalemia
• C. Hyponatremia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Hypothyroidism. Radioactive iodine therapy is used to treat hyperthyroidism by destroying thyroid tissue and reducing hormone production. This can lead to an underactive thyroid, resulting in hypothyroidism. Hyperkalemia (choice B) is an elevated potassium level, usually not associated with radioactive iodine therapy. Hyponatremia (choice C) is a low sodium level, which is also not a common side effect of this therapy. Hypercalcemia (choice D) is an elevated calcium level, unrelated to radioactive iodine therapy for hyperthyroidism.

4. A client with diabetes mellitus visits a health care clinic. The client's diabetes was previously well controlled with glyburide (Diabeta), 5 mg PO daily, but recently the fasting blood glucose has been running 180-200 mg/dl. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

• A. Prednisone (Deltasone)
• B. Atenolol (Tenormin)
• C. Phenelzine (Nardil)
• D. Allopurinol (Zyloprim)

Correct answer: A

Rationale: Prednisone, a corticosteroid, can increase blood glucose levels by promoting gluconeogenesis and decreasing glucose uptake by cells. This medication can lead to hyperglycemia in patients, especially those with diabetes mellitus. Atenolol (Tenormin) is a beta-blocker and is not known to significantly affect blood glucose levels. Phenelzine (Nardil) is a monoamine oxidase inhibitor used to treat depression and anxiety disorders; it does not typically impact blood glucose levels. Allopurinol (Zyloprim) is a xanthine oxidase inhibitor used to manage gout and does not interfere with blood glucose regulation.

5. A male client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should nurse Lina provide?

• A. Administer desmopressin while the suspension is cold.
• B. Your condition isn't chronic, so you won't need to wear a medical identification bracelet.
• C. You may not be able to use desmopressin nasally if you have nasal discharge or blockage.
• D. You won't need to monitor your fluid intake and output after you start taking desmopressin.

Correct answer: C

Rationale: The correct instruction is choice C: 'You may not be able to use desmopressin nasally if you have nasal discharge or blockage.' Nasal congestion or blockage can interfere with the absorption of nasally administered desmopressin. Choices A, B, and D are incorrect. Choice A is unnecessary as the temperature of the suspension does not impact desmopressin administration. Choice B is incorrect as wearing a medical identification bracelet is essential for individuals with diabetes insipidus to alert healthcare providers in case of emergencies. Choice D is incorrect as monitoring fluid intake and output is crucial when taking desmopressin to ensure proper hydration and medication effectiveness.

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